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Forms & Downloads

OWCP forms, explained.

The most common OWCP forms you'll encounter — with plain-language explanations of what each one does, when you'll need it, and who completes it.

OWCP uses specific forms for each phase of a federal workers' compensation claim — CA-1 (traumatic injury notice), CA-2 (occupational disease), CA-7 (wage-loss compensation), CA-16 (treatment authorization), CA-17 (duty status report), and CA-20 (attending physician's report). Below, the most common forms are explained in plain language — what each does, when you'll need it, and who completes it — followed by the complete directory of all DOL OWCP forms with links to the official PDFs. Looking for NuThera's own intake forms? Visit Patient Forms.

Note: Official OWCP forms are published and maintained by the U.S. Department of Labor. Always verify you're using the current version on the DOL OWCP forms page. The guides below are NuThera's plain-language companions — not replacements for the official forms.

CA-1Official DOL form

Federal Employee's Notice of Traumatic Injury

File a CA-1 for a traumatic injury — an event, accident, or incident that occurred during a single workday.

When
Within 30 days of the injury. Sooner is better.
Who submits
The injured worker, through their agency and ECOMP.
NuThera role
Our providers complete the medical sections with the causation language OWCP requires.
CA-2Official DOL form

Federal Employee's Notice of Occupational Disease

File a CA-2 for an occupational disease or illness that developed over time — repetitive strain, chronic conditions, exposure-related illness.

When
Within 3 years of when you became aware the condition was related to your federal employment.
Who submits
The injured worker, through their agency and ECOMP.
NuThera role
We document the clinical progression and work-related causation your claim will be judged on.
CA-2aOfficial DOL form

Notice of Recurrence

File a CA-2a when a previously accepted work injury flares up again after you've returned to work — without a new workplace incident.

When
As soon as the recurrence causes disability or the need for renewed treatment.
Who submits
The injured worker, through their agency and ECOMP.
NuThera role
We document how your current condition connects to the original accepted injury — the medical link OWCP scrutinizes most on recurrence claims.
CA-7Official DOL form

Claim for Compensation

The form for claiming wage-loss compensation when you can't work — used after Continuation of Pay ends (traumatic injuries) or from the start for occupational disease claims.

When
Before COP ends (around day 30–40), then every two weeks while wage loss continues. Use CA-7a for intermittent lost time.
Who submits
The injured worker, through their agency and ECOMP.
NuThera role
Your CA-7 is only as strong as the medical evidence behind it. We keep work-status documentation current so compensation isn't interrupted.
CA-16Official DOL form

Authorization for Examination and/or Treatment

Authorizes initial medical evaluation and treatment for a work-related injury within the first 60 days of injury.

When
Issued by your employing agency within 4 hours of your injury request.
Who submits
Your supervisor or agency, provided to you to give to your doctor.
NuThera role
Bring your CA-16 to your first visit. Our team will treat and document according to OWCP standards.
CA-17Official DOL form

Duty Status Report

Your treating physician's report on your ability to perform your regular duties. Critical for return-to-work planning.

When
At initial evaluation and at each significant change in work status.
Who submits
Completed by your treating provider, submitted to your agency.
NuThera role
Our providers complete CA-17s at each visit when work status changes.
CA-20Official DOL form

Attending Physician's Report

The detailed medical report connecting your diagnosis to work-related causation. One of the most important documents in an OWCP claim.

When
After initial evaluation, and updated throughout treatment.
Who submits
Completed and submitted by your treating provider.
NuThera role
This is where proper causation narratives determine claim acceptance or denial. Our providers are trained in writing CA-20s that meet OWCP standards.
NuTheraOfficial DOL form

NuThera DOL / OWCP Pre-Visit Intake Packet

Our pre-visit intake packet for federal workers and DOL-covered patients — demographics, medical history, medications, and consents. Fill it out on your computer before your first visit; claim-stage forms are completed with our team in the clinic.

When
Before your first appointment. Arriving with it completed saves 20+ minutes at check-in.
Who submits
The patient — return by email, fax, or bring it to your visit.
NuThera role
This is our own form, built around what OWCP claims actually require. Our team reviews it with you at your first visit.
Work StatusNuThera form

NuThera Work Status / Restrictions Form

Internal NuThera form documenting current work restrictions, duty status, and clinical reasoning for employer and agency use.

When
Provided at the end of each visit where restrictions are set or updated.
Who submits
Completed by your NuThera provider and given to you to share with your supervisor.
NuThera role
NuThera-branded form that covers both personal-injury and workers' compensation cases with clear restriction categories.

Provided by your NuThera provider at your visit — no download needed.

Complete DOL forms directory.

Every form published by the Department of Labor for the federal workers’ compensation program, with links to the official PDFs. Forms marked “fillable” can be completed on your computer before printing.

Filing & claim forms

  • CA-1
    Federal Notice of Traumatic Injury and Claim for Continuation of Pay/CompensationFillable
  • CA-2
    Notice of Occupational Disease and Claim for CompensationFillable
  • CA-2a
    Notice of RecurrenceFillable
  • CA-7
    Claim for CompensationFillable
  • CA-7a
    Time Analysis Form — intermittent lost time and leave repurchaseFillable
  • CA-7b
    Leave Buy Back (LBB) Worksheet / Certification and Election
  • CA-12
    Claim for Continuance of CompensationFillable
  • CA-10
    What a Federal Employee Should Do When Injured at Work (information sheet)
  • CA-35
    Evidence Required in Support of a Claim for Occupational Disease

Medical & work status

  • CA-16
    Authorization for Examination and/or Treatment

    Not publicly downloadable. Issued by your employing agency via AQS or ECOMP — ask your supervisor or workers' comp coordinator, then bring it to your first visit.

  • CA-17
    Duty Status ReportFillable
  • CA-20
    Attending Physician's ReportFillable
  • CA-27
    Authorization Request / Letter of Medical Necessity for Opioid Medications

    Provider-only form, available to registered medical providers inside the OWCP Web Bill Portal. NuThera handles this for our patients.

  • OWCP-5a
    Work Capacity Evaluation — Psychiatric/Psychological ConditionsFillable
  • OWCP-5b
    Work Capacity Evaluation — Cardiovascular/Pulmonary ConditionsFillable
  • OWCP-5c
    Work Capacity Evaluation — Musculoskeletal ConditionsFillable

Reimbursement & payment

  • OWCP-915
    Claim for Medical Reimbursement (replaces CA-915)Fillable
  • OWCP-957A
    Medical Travel Refund Request — MileageFillable

    Since March 2026, also submittable online through the OWCP Claimant Portal.

  • OWCP-957B
    Medical Travel Refund Request — ExpensesFillable

    Since March 2026, also submittable online through the OWCP Claimant Portal.

  • OWCP-20
    Overpayment Recovery QuestionnaireFillable
  • SF-1199A
    Direct Deposit Sign-Up Form

Rehabilitation & return to work

  • OWCP-16
    Rehabilitation Plan and AwardFillable
  • OWCP-17
    Rehabilitation Maintenance CertificateFillable
  • OWCP-44
    Rehabilitation Action ReportFillable
  • CA-2231
    Claim for Reimbursement — Assisted ReemploymentFillable

Survivor & death benefits

  • CA-5
    Claim for Compensation by Surviving Spouse and/or ChildrenFillable
  • CA-5b
    Claim for Compensation by Parents, Siblings, Grandparents, or GrandchildrenFillable
  • CA-6
    Official Supervisor's Report of Employee's Death
  • CA-40
    Designation of a Recipient of the FECA Death Gratuity Payment (5 U.S.C. § 8102a)Fillable
  • CA-41
    Claim for Survivor Benefits — FECA Section 8102a Death GratuityFillable
  • CA-42
    Official Notice of Employee's Death — FECA Section 8102a Death GratuityFillable
  • CA-1031
    Letter to Dependents to Verify Claimant Support
  • CA-1074
    Letter to Parents in Death Claim Development

Special cases

  • CA-721
    Notice of Law Enforcement Officer's Injury or Occupational DiseaseFillable
  • CA-722
    Notice of Law Enforcement Officer's DeathFillable
  • CA-278
    Claim for Reimbursement — War Hazards Compensation Act
  • CA-1108
    Statement of Recovery Letter — Long FormFillable
  • CA-1122
    Statement of Recovery Letter — Short FormFillable

For medical providers (NuThera handles these for you)

Tip: if a DOL form won’t open in your browser, download it and open it in Adobe Acrobat Reader — the official PDFs sometimes don’t display correctly in browser viewers. Directory verified June 2026 against the official DOL forms page.

Need help with a specific form?

Call NuThera. Our team completes OWCP medical documentation every day.